Zygomatic bone: Anatomic bases for osseointegrated implant anchorage

Purpose: The aim of the present study was to evaluate zygomatic bone thickness considering a possible relationship between this parameter and cephalic index (Cl) for better use of Cl in the implant placement technique. Materials and Methods: Cl was calculated for 60 dry Brazilian skulls. The zygo matic bones of the skulls were divided into 13 standardized sections for measurement. Bilateral measurements of zygomatic bone thickness were made on dry skulls. Results: Sections 5, 6, 8, and 9 were appropriate for implant anchorage in terms of location. The mean thicknesses of these sections were 6.05 mm for section 5, 3.15 mm for section 6, 6.13 mm for section 8, and 4.75 mm for section 9. In only 1 section, section 8, did mean thickness on 1 side of of the skull differ significantly from mean thickness on the other side (P <.001). Discussion: For the relationship between quadrant thick ness and Cl, sections 6 and 8 varied independently of Cl. Section 5 associated with brachycephaly, and section 9 associated with subbrachycephaly, presented variations in the corresponding thickness. Conclusion: Based on the results, implants should be placed in sections 5 and 8, since they presented the greatest thickness, except in brachycephalic subjects, where thickness was greatest in section 5, and in subbrachycephalic subjects, where thickness was greatest in section 9. Cl did not prove to be an appropriate parameter for evaluating zygomatic bone thickness for this sampling.

Anatomical study of the retroarticular process in dry human skulls

Introduction: The retroarticular process is a bony prominence formed by the thickening of the lateral border of the mandibular fossa, forming the posterior wall of the temporomandibular joint. Since little is known and discussed about the retroarticular process, our aim was to study its presence, shape and size, relating these findings to the shape of the skulls according to the horizontal cephalic index. Materials and Methods: We used 400 dry human skulls of the Institute of Science and Technology - UNESP Anatomy Laboratory. Each skull was classified in brachycranics, mesocranics or dolichocranics, and then positioned on a craneostat to measure the height of the retroarticular process from its lower extremity to the auriculo-orbital plane. The width was obtained by measuring the base of the process on its longer lateral axis. Results: The retroarticular process was found bilaterally in 397 skulls (99.25%). All the processes were classified into the following shapes: pyramidal (35.55%), tubercular (31.78%), mammilar (20.73%), crest-like (9.05%) and molar shape (2.89%); 254 skulls (63.50%) showed the same type of process at the right and left sides (Kappa=0.496, moderate agreement). The average height and width were 5.28 mm and 12.81 mm, respectively. Conclusion: The retroarticular process was found in almost all the skulls examined. There are no significant evidences about the relationship among the presence, shape and size of the retroarticular process and the shape of the skulls according to the horizontal cephalic index. However, our findings led us to infer that there would be a functional relationship between the process and the temporomandibular joint.

Postoperative evaluation of surgery for craniosynostosis based on image registration techniques

Craniosynostosis consists of a premature fusion of the sutures in an infant skull, which restricts the skull and brain growth. During the last decades there has been a rapid increase of fundamentally diverse surgical treatment methods. At present, the surgical outcome has been assessed using global variables such as cephalic index, head circumerence and intracranial volume. However, the variables have failed in describing the local deformations and morphological changes, which are proposed to more likely induce neurological disorders.

Feature-invariant image registration method for quantification of surgical outcomes in patients with craniosynostosis: a preliminary study

Craniosynostosis consists of a premature fusion of the sutures in an infant skull that restricts skull and brain growth. During the last decades, there has been a rapid increase of fundamentally diverse surgical treatment methods. At present, the surgical outcome has been assessed using global variables such as cephalic index, head circumference, and intracranial volume. However, these variables have failed in describing the local deformations and morphological changes that may have a role in the neurologic disorders observed in the patients. This report describes a rigid image registration-based method to evaluate outcomes of craniosynostosis surgical treatments, local quantification of head growth, and indirect intracranial volume change measurements. The developed semiautomatic analysis method was applied to computed tomography data sets of a 5-month-old boy with sagittal craniosynostosis who underwent expansion of the posterior skull with cranioplasty. Quantification of the local changes between pre- and postoperative images was quantified by mapping the minimum distance of individual points from the preoperative to the postoperative surface meshes, and indirect intracranial volume changes were estimated. The proposed methodology can provide the surgeon a tool for the quantitative evaluation of surgical procedures and detection of abnormalities of the infant skull and its development.

High body mass index is not a barrier to physical activity: Analysis of international rugby players' anthropometric data

Recent data indicate that levels of overweight and obesity are increasing at an alarming rate throughout the world. At a population level (and commonly to assess individual health risk), the prevalence of overweight and obesity is calculated using cut-offs of the Body Mass Index (BMI) derived from height and weight. Similarly, the BMI is also used to classify individuals and to provide a notional indication of potential health risk. It is likely that epidemiologic surveys that are reliant on BMI as a measure of adiposity will overestimate the number of individuals in the overweight (and slightly obese) categories. This tendency to misclassify individuals may be more pronounced in athletic populations or groups in which the proportion of more active individuals is higher. This differential is most pronounced in sports where it is advantageous to have a high BMI (but not necessarily high fatness). To illustrate this point we calculated the BMIs of international professional rugby players from the four teams involved in the semi-finals of the 2003 Rugby Union World Cup. According to the World Health Organisation (WHO) cut-offs for BMI, approximately 65% of the players were classified as overweight and approximately 25% as obese. These findings demonstrate that a high BMI is commonplace (and a potentially desirable attribute for sport performance) in professional rugby players. An unanswered question is what proportion of the wider population, classified as overweight (or obese) according to the BMI, is misclassified according to both fatness and health risk? It is evident that being overweight should not be an obstacle to a physically active lifestyle. Similarly, a reliance on BMI alone may misclassify a number of individuals who might otherwise have been automatically considered fat and/or unfit.